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By the time they reach age 18, about 12 percent of American children experience a confirmed case of maltreatment in the form of neglect, physical, sexual, or emotional abuse, according to a new study. “Maltreatment is on the scale of other major public health concerns that affect child health and well-being,” one researcher said. “Because child maltreatment is also a risk factor for poor mental and physical health outcomes throughout life, the results of this study provide valuable epidemiologic information.”

The numbers are even more sobering for black and Native American children, with one in five black children and one in seven Native American children experiencing maltreatment during the time period studied. The results are published in the June 2 issue of the journal JAMA Pediatrics.

The authors estimated the cumulative prevalence of confirmed childhood maltreatment by age 18 using the National Child Abuse and Neglect Data System Child File, which includes information on all U.S. children with a confirmed report of maltreatment. Analysis of data between 2004 and 2011 showed that over 5.6 million children had experienced maltreatment during this time period.

“Confirmed child maltreatment is dramatically underestimated in this country. Our findings show that it is far more prevalent than the 1 in 100 that is currently reported,” said first author Christopher Wildeman, associate professor of sociology and faculty fellow at the Institution for Social and Policy Studies at Yale.

Wildeman, his colleagues at other institutions, and in the Yale Departments of Pediatrics and Sociology, provide cumulative, rather than annual, estimates that confirmed child maltreatment is common.

“Maltreatment is on the scale of other major public health concerns that affect child health and well-being,” he said. “Because child maltreatment is also a risk factor for poor mental and physical health outcomes throughout life, the results of this study provide valuable epidemiologic information.”